Matrix metalloproteinase 9, ceruloplasmin, podocalyxin, Dickkopf-related protein 4 and carbonic anhydrase IX were increased, whereas AQP-1, extracellular matrix metalloproteinase inducer, neprilysin, dipeptidase-1, and syntenin-1 were decreased in urinary exosomes derived from RCC patients. Here, DKK4 is linked to renal cell carcinoma.